On April 22, an important Chinese delegation of policymakers and healthcare administrators – amongst others the mayor of Shanghai – visited Leyden Academy on Vitality and Ageing to exchange ideas on ageing. Also present were two representatives of the Dutch Ministry of Health, Welfare and Sport, the former Chancellor of Leiden University, the former Dean of Leiden University Medical Centre (LUMC), the Head of Department Public Health and Primary Care/campus The Hague, and a representative from Aegon International.
Ageing populations
China and the Netherlands are incomparable when it comes to size and scale. The city-region of Shanghai alone is as big as the Netherlands, Belgium, Luxembourg and the north of France combined, with a population of 40 million inhabitants. A commonality is that both countries are dealing with an ageing population and related challenges such as ageism, loneliness, health disparities, and access to long-term care. This was the core topic of the work visit.
Prevention
David van Bodegom, professor of ‘Vitality in an ageing population’ at LUMC, spoke about the importance of collective prevention to postpone frailty in old age. His research shows that daily physical exercise in peer groups (so-called Vitality Clubs) do not only benefit the health condition of older people, but also help to prevent loneliness. While people in the Netherlands are not used to outdoor group exercise, the Chinese population is. Besides Tai-chi it is very popular among older women to dance on public squares, according to the Chinese officials. The public government stimulates role models and promotes these activities by offering public spaces to exercise. Van Bodegom: ”We can learn from China in that regard.”
Olderpreneurs and retirement
Digital learning expert Marie-Louise Kok talked about the desire of many Dutch people to stay active after their retirement: 73% of employees want to keep working after retirement and 10-15% of people over 50 want to start their own business.
Unfortunately, the general focus on young entrepreneurs leads to a lack of confidence in older entrepreneurs. Therefore, Leyden Academy and Aegon developed Silver Starters, a blended learning program for people over 50 years who want to start their own business. An evaluation showed that 85% of the participants was more active, 67% had more self-confidence and 67% was better prepared for the future. The officials shared that in China men retire at 60 and women at 55 years of age. Then they make room for the next generation and watch after their grandchildren, so their children can focus on work. When they need help, their children take care of them.
Sustainability of older-persons care
Tineke Abma, Executive-director of Leyden Academy and professor of ‘Participation of older people’ at LUMC, spoke about the sustainability of older-person care in European perspective. An international comparison (The Netherlands, Denmark, Germany, and England) showed a wide variety of approaches in financial coverage, access to long-term care and the role of informal care.
The general trend in most of the studied countries is to facilitate older people to live self-sufficiently at home as long as possible. Six major issues are closely interrelated and are subject to public debate in each country: cost-sharing, privatization of care, (the burden of) informal care, staff shortages, quality of care and migrant workers.
The officials from China recognized these issues. In the bigger cities like Shanghai there is a lack of healthcare workers, which is fulfilled by people from the rural areas. Hence, lack of personnel is not an issue, but lack of skilled personnel is. Furthermore, the government stimulates old-for-old program where the younger generations take care of the older ones, for which they receive financial compensation.
Personalized care
Josanne Huijg senior investigator and staff-member of Leyden Academy presented an innovation program in long-term care for older people, called the ‘Enjoying life approach’. This approach starts with knowing the client’s identity and focusses on well-being. It envisions a paradigm shift from a standardized, biomedical to a personal approach: from disabilities to possibilities, from diseases to wellbeing, from needs to desires, and from protocols to relationships. The officials expressed their interest in personalized care, because in China care is standardized. They also wondered whether this requires other ways of measuring quality, and how cost-effective this approach is.
The Chinese delegation expressed that they were very impressed by the high quality presentations, and were inspired by the visit. The staff of Leyden Academy and other participants really enjoyed the interactive exchange.
We would like to express our gratitude to Marco Keim, the CEO of Aegon International, for arranging this visit, as well as to Wouter Knecht and Christel de Boks. Many thanks also for the advice from former dean Pancras Hogendoorn, former Rector Magnifici of Leiden University, Carel Stolker and Douwe Breimer, Wilco Achterberg, as well as Annemarie Montulet. Additionally, we appreciate the contributions of Mattijs E Numans from LUMC, Rosalien Stroot and Marjolein Don from the Ministry of Health, Welfare and Sport, and interpreter Echo Zhang for their involvement and input.
Is your country also interested in care for older persons in the Netherlands, in the research projects and activities of Leyden Academy, and in exchanging ideas? Let us know: info@leydenacadeny.nl.